Clinical application of additive manufacturing in maxillofacial prosthetics: A scoping review

Purpose: Digital workflows provide significant advances in prosthodontics, especially in terms of accuracy, reduced treatment duration, and quality of life. Moreover, additive manufacturing (AM) is particularly adapted for the fabrication of personalized complex prototypes required for the prosthetic rehabilitation of maxillofacial defects. However, the integration of AM in maxillofacial prosthetics (MP) protocols is challenging. The purpose of this scoping review was to evaluate the clinical contribution of AM to the management of patients requiring MP. Methods: This scoping review followed the PRISMA recommendations. Searches were conducted until December 2024 using the PubMed, Scopus, and Web of Science databases. Selection was performed by reviewing titles and abstracts, followed by full-text evaluation according to the established inclusion and exclusion criteria. In vitro studies and case reports were excluded. Results: Of the 1526 retrieved articles, 16 were included. These clinical studies were 14 case series and 2 cohort studies, with a sample size averaging ∼8 participants per study. The applications were 3D-printed prostheses, prosthetic prototypes, master casts or molds, and implant guides. These articles demonstrated that AM enhanced clinical management of MP in terms of cost, production time, aesthetics, retention, accuracy, quality of life, and comfort. The replication of skin texture remained the only criterion requiring improvement. Conclusions: Workflows integrating computer-aided design and AM offer alternatives to conventional procedures for the management of MP. However, the organization of digital workflows suggests an initial investment related to installation costs and the recruitment of trained technicians. Larger-scale studies with extended follow-up periods are needed to establish whether a digital workflow incorporating AM represents a standard treatment approach.